The letter came to this city's main cardiac hospital late last month. It was unsigned and handwritten, but its message was clear: It threatened the hospital's top doctors and warned them to leave their jobs immediately.
No one knows who sent the letter, but the relentless violence here is often baffling. Four of the hospital's top surgeons stopped going to work. So did six senior cardiologists. Some left the country.
It was far from an isolated incident.
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